Meet the women fighting to save a small city from the opioid crisis

“One of my cubs is missing.”

Connie Raynor-Elliott drove through the streets of Sault Ste. Marie, Ontario searching for Jake, a young man in his twenties who’s been addicted to fentanyl and meth since he was about 15. She was frantic because it was a freezing winter day and he wasn’t at his typical hangouts.

“It’s unusual. He usually meets me,” said Raynor-Elliott, looking left and right along the streets for any sign of Jake, who’s spent years couchsurfing and doesn’t currently have a working cell phone. She passed by a garage emblazoned with “Junkies Beware” graffiti.

“If we find him, I’m going to convince him to go to detox because he needs a safe place right now,” she said, turning down another road to check a different spot. There are snacks in the back of the Rav4 that’s easily recognizable by its oversized bumper sticker that reads: “Save a Life Report Your Local Fentanyl Dealer.”

Jake is one of more than 1,000 drug users from Sault Ste. Marie, also known as “the Soo,” who Raynor-Elliott says she has helped with their addictions in a city where overdose rates have risen to an estimated five a day, according to local harm reduction workers.

For years, Raynor-Elliott has been on a crusade both online and in real life to rescue young people from the throes of addiction and get them to treatment.

“All these kids are my cubs. It’s just a name that has stuck,” she said.

Raynor-Elliott, who’s in her 50s and says her fiery red hair matches her personality, started a group called Save Our Young Adults from Prescription Drug Abuse (SOYA) after her son’s friend died of an opioid overdose in 2011. Since then, its Facebook group has grown to more than 900 members who post overdose alerts, motivational quotes, and requests for help and donations for drug users. A group of volunteers — including mothers of children who have overdosed — help drive people to doctor’s appointments, get into rehab, and find housing.

Being Mama Bear and working with drug users is Raynor-Elliott’s passion and purpose in life. Sometimes she’ll meet with cubs if even for a few minutes during breaks from her day job at the Ontario Lottery and Gaming Corporation, one of the city’s major employers.

Raynor-Elliott sees herself as filling a void left by a lack of social services in the northern steel town of fewer than 75,000 people where limited options for drug users are mostly open weekdays from nine to five. But she’s not a social worker and isn’t formally trained in addictions, something that makes her a controversial figure among official harm reduction and healthcare providers in the city.

“Some of them don’t agree with what I do,” she admitted, adding that everything she knows about this issue is based on her own experiences. “I’m not following their rules as much as they want me to.”

That’s why many official harm reduction and healthcare workers in the Soo question the rogue tactics used by advocates like Mama Bear, fearing they can create more chaos amid a worsening drug crisis. At the same time, however, the crisis playing out in smaller communities across Canada and the U.S. inevitably falls on people like her due to limited services — a dynamic that’s distinct from larger cities where the issue receives more attention. But both camps share a desire to bring about change and more resources dedicated to fighting the opioid crisis they say is resulting in more overdoses and deaths in the city than ever before.

“I call it the Soo’s biggest dirty secret,” Raynor-Elliot said, still on the lookout for Jake. “Our city’s in major trouble.”

Her cell phone pings constantly with texts from “cubs” looking for a hot meal or a ride somewhere. Sometimes they want cash, which she says she doesn’t give them.

“I’ll give you clothes, I’ll give you a pack of smokes. But I really try not to enable them.”

'STIGMA AND JUDGEMENT'

Until a few weeks ago, Desiree Beck was the only harm reduction outreach worker in Sault Ste. Marie, the surrounding Algoma District, and several First Nations communities. She serves on the city’s drug strategy committee and oversees initiatives like the needle exchange and the distribution of the opioid antidote naloxone. Sometimes she’ll drive all day and into the night for work. She and other advocates have long called for more funding and resources to help curb the opioid crisis in the city. It’s taken a toll on her emotionally, and her clients have been grappling with the trauma that comes with having near-death experiences on a regular basis.

“Obviously they aren’t feeling adequately supported, and we wonder why people go underground,” Beck told VICE News in an interview. One day at the drop-in centre where she works, an older community member shouted that everyone who uses drugs there should just be left to die.

“It’s exactly the type of stigma and judgment that makes the problem worse,” she said, adding that many clients are scared of reaching out to law enforcement or going to the hospital for fears of being belittled or judged for their drug use.

And that type of stigma is often heightened in close-knit communities, meaning that solutions to the drug crisis being pursued in bigger cities, such as supervised injection sites, might not be well-received or even work in smaller cities.

“Sure, in the Soo we could have one of those. I don’t think it would be well-utilized because, in addition to geographical barriers, we have an inadequate transit system. There’s not ways for people to get to us,” Beck said.

“There are people who won’t access our health unit because their mother or their sister or their next-door neighbour, a kid they grew up with works there. So, what a heat score to go to a supervised injection site when your next-door neighbour is going to work there. Most places it’s that six degrees of separation. We don’t have that: It’s one degree of separation here.”

Beck explained that the shame can be compounded by the fact that many users feel alienated in the midst of so few resources available to them during the evenings and weekends.

“It’s sending the message that their crisis should only happen during the convenient hours of nine to five,” said Beck, who often works on her own time without pay. “It completely invalidates a lot of the other things that go on in this community. People struggle with mental health issues at all hours of the day. And they need support.”

Beck said that also includes basic things like an improved transit system so that people can be self-sufficient and access the services that do exist, and more affordable housing that helps break the cycle of poverty that can contribute to addiction.

While drug use in the Soo has been an issue for years, especially with the decline of the once-thriving steel industry and the shuttering of the paper mill, things became really bad by December of 2016. Beck told local media at the time about spikes in overdoses and deaths linked to bootleg fentanyl that's tainting the local illicit drug supply. It’s hard to say whether more people were using drugs, but it’s clear that the potency of the drugs had reached new and dangerous levels.

Calls continued for beefed-up resources and frontline staff.

The following April, Beck and local police officers hosted a special town hall to warn the city about the dangers of fentanyl. It signalled a shift in the Soo’s willingness to air out the uncomfortable topic of drug use.

“It’s scary to understand how devastating this drug can be on ta community,” Staff Sgt. Duguay told the crowd of more than 150 people who heard from other first responders about the rising numbers of overdoses.

In September, the Sault Ste. Marie Police Service and the Algoma Health Unit of which Sault Ste. Marie is a part, issued a warning that a new opioid had made its way into town. After one of the police service’s largest drug seizures, samples were sent to Health Canada, which identified cyclopropyl fentanyl — the first time that fentanyl analogue had been discovered in the region. It’s unclear exactly what effect it has on humans, but police said they were concerned about a troubling and potentially fatal trend hitting the drug supply.

Two months later in November, police officers and paramedics responded to a record eight overdoses in one night, and issued a public warning about it. But the real number that occurred that night is likely much higher, according to Beck, because many drug users are accessing naloxone kits and often don’t call 911 in the event of an overdose.

“It was a massive wake-up call,” she said.

By the time the winter holidays were over, Beck had lost at least three more clients to overdoses, and a support group for frontline workers was formed to help them all cope with the workload and grief that comes with it. One silver lining is that her agency hired a second harm reduction outreach worker.

“Our community is so small,” she said. “And we all need to collectively come together to actually acknowledge there’s a problem here.”

LACK OF TREATMENT SPACE

For Terri Nicholson, it’s frustrating and draining to see patients fall through the cracks even when they do make it to the hospital for overdoses or other health issues related to using drugs. As the only person in her role at the Sault Area Hospital, she tries to have meaningful interactions with everyone who’s referred to her. But lately, it’s been difficult to keep up as the emergency room has been inundated with calls.

There used to be about four or five people admitted for overdoses a month, and recently that has gone up to more than 40. “In a 10-day span we had 22,” Nicholson explained in an interview at the hospital.

On top of that, she commonly sees patients suffering from infections and abscesses from dirty needles or other harmful methods of drug consumption. Those can be fatal and happen far more often than people realize, she said.

“We’re in an overdose crisis … I think it’s going to get worse before it gets better,” Nicholson said. “Fentanyl is touching every age group. But we don’t have the services to provide … We don’t have a treatment centre. We don’t have a medical detox. We don’t have a safe place for people to go every day for treatment.”

There isn’t a system in place to reach those who are undecided as to whether they want to attempt treatment, she said. If a patient is referred to Nicholson and she doesn’t get to them in time and they decide to leave, she might never see them again. Earlier last year, a young man left the emergency room before she could see him, and she found out he died of an overdose in a bus shelter that night.

“I do this work because I love people, and I talk to people that are in desperate conditions,” said Nicholson. “When I meet a new person, I almost don’t want to build too much rapport because it’s hard. But rapport is what makes this work.”

'BRASS KNUCKLES'

Connie Raynor-Elliott is still looking for Jake. She hops out of her car and goes into the Tim Hortons, one of his favourite places. She asks a man to check inside the washroom for her. But Jake isn’t there either.

“He’s a runner too,” she laughs. “Because he knows he’s going to get in trouble with me. He gets the lecture. And then he usually breaks down, he starts to cry. Then we get him safe again. Cuz he’s sick, right? He’s really sick.”

When she first started the group years ago, Raynor-Elliott says she let her emotions get the best of her. She used to let young users stay in her home, and one time she says she had it out with a local drug dealer who she says sold her biological son OxyContin. Her son is sober now, but he was going on regular binges and she helped him detox at home.

“I made a couple calls, and I found out where this dealer lived,” she said, sitting at her living room table topped with a porcelain figurine of a large brown bear with baby cubs. The house is of full of other bear-themed decor. “This dealer went after my son with brass knuckles. So Mama Bear turned grizzly.”

She says she grabbed a bat and knocked on the dealer’s back door. “He started yelling to get out,” she recalled. “And he opened the door and he went down the stairs … The bat slipped.”

It was hard, but she hasn’t done anything like that in years, she said. “I smartened up. I was reckless.”

She tries to remain focused on the wellbeing of the cubs, even when they run away or lash out.

“If somebody is really happy with you, you have to back up and say, ‘I’m not doing this right,’” said Raynor-Elliott. “If they’re actively using and they’re happy with you, no, you gotta put a bit more pressure on them.”